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Objectives
Infectious Diseases and Immunizations of Refugees and Immigrants
Epidemiology of New Immigrants in the United States
Immigration to the United States
Internationally Adopted Children in the United States
Countries of Origin
Barriers to Care for Immigrants
International Health: Helpful On-Site Services
Goals of Initial Assessment
Suggested Screening for Infectious Diseases for New Immigrants
Screening Test Results of Refugee Children (% positive)
Universal Screening is Appropriate for Refugees and Most Immigrants
Tuberculosis in an Immigrant Child
Tuberculin Skin Testing
Percent of Children with PPD > 10 mm after BCG Administered at Birth
BCG and PPD Interpretation
Age at Time of BCG and Skin Test Reaction
Management of Positive PPDs
Hepatitis B in a Refugee
Testing for Hepatitis B
Interpretation of Hepatitis B Serologic Tests
Eosinophilia in a Liberian Refugee
Eosinophilia in New Arrivals
Challenges in Management of Eosinophilia in New Immigrants
Study of Eosinophilia in a Refugee Population
Proportion of Refugees with Eosinophilia by Region of Origin
Prevalence of Positive Serology by Presence of Stool Pathogen
Prevalence of Positive Serology for Specific Parasites by Level of Eosinophilia
Conclusions Regarding Evaluation of Eosinophilia in Refugees
Treatment of Intestinal Parasites
Immunization Challenges
Controversies in Immunization of Internationally Adopted Children
What is the prevalence of antibody to vaccine-preventable diseases in refugee children?
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Conclusions about Prevalence of Antibody to VPDs
Cost-Effectiveness of Screening for Varicella Antibody
Cost-effectiveness of serotesting for varicella antibody
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Conclusions Regarding Serotesting and Varicella History
Validity of Varicella History in Refugees of All Ages
Varicella History and Antibody and PPV and NPV of History
Conclusions Regarding Validity of Varicella History
Rapid Testing for Immunity to Vaccine Preventable Diseases
Conclusions: Infectious Disease Screening and Vaccines for Refugees

Elizabeth Barnett, M.D. - Boston Medical Center

Health Assessment of New Immigrants